Recognizing eating disorders in men and boys

Historically, eating disorders in men have been overlooked. But today, cisgender men now make up about one-third of people diagnosed with an eating disorder, with binge eating disorder being the most common among this population. 

Eating disorders are serious, potentially life-threatening mental health conditions for people of all genders. However, men who live with these conditions may face unique challenges. So if you’re a man who struggles with your relationships with food, exercise, or body image, know that you’re not alone. Learning more about eating disorders in men can help you get the support you deserve.

A note on gendered language: People of all gender identities and expressions can develop conditions like anorexia, bulimia, and orthorexia. And yet, there’s a prevailing myth that eating disorders are largely a biological women’s issue. Sadly, eating disorders in cisgender men and boys often go undiagnosed because of this misconception. However, we want to acknowledge that other populations, including trans folks, often don’t get the eating disorder care they deserve. While this piece focuses on the experience of cisgender men, our hope is that in raising awareness of these disparities, we can improve access to eating disorder treatment for people of all genders.

What eating disorders often look like in men

The symptoms of eating disorders are largely universal. Just like any other gender, men can become overly weight-conscious or fixated on attaining an idealized body. 

While women continue to experience these conditions at higher rates, certain conditions like muscle dysmorphia — a form of body dysmorphia sometimes referred to as “bigorexia,” — seem to affect men disproportionately. While not classified as an eating disorder, “bigorexia” is a body image distortion that involves a fixation on gaining muscle. It can lead to serious health issues. 

Signs to watch for include:

• Suddenly losing or gaining weight, or fluctuating
• Appearing more “bulky” than usual
• Experiencing lower testosterone levels
• Fixating on fitness, muscle tone, weightlifting, leanness, etc.
• Being preoccupied with food or supplements intended to promote muscle gain
• Exercising compulsively, even when injured
• Maintaining rigid eating and/or exercising habits 
• Misusing steroids or other performance-enhancing drugs
• Withdrawing from loved ones or avoiding activities they used to enjoy

Common causes of eating disorders in men

Many of the causes of eating disorders in men mirror those of other genders. However, a few risk factors that may particularly affect men  include:

• Sports and athletics: Men who play sports or who compete in bodybuilding competitions may be more vulnerable to eating disorders. For example, they may engage in disordered behaviors to achieve a certain weight (i.e. to be eligible for competition within a certain weight class) or to improve their athletic performance.
• Weight history: Men with eating disorders often have a history of being overweight or obese, especially during childhood. This is different from women, who typically have stable weight histories prior to the onset of their eating disorder.
• Substance misuse: In addition to higher rates of steroid and performance-enhancing drug use, men with eating disorders appear to misuse other substances (i.e. drugs or alcohol) at higher rates than women with eating disorders.
• Sexual orientation: Being gay or bisexual isn’t a risk factor for eating disorders. However, research shows that eating disorders appear to be 10 times more prevalent among gay and bisexual men than heterosexual men.
• Mental health: Men with eating disorders report higher rates of shame and depression. This might be because of damaging societal norms that force men to conceal their vulnerabilities for fear of being perceived as weak or feminine. 
• Trauma and abuse: Approximately 30% of people with eating disorders report a history of sexual abuse. But due to the gendered stigma around this form of trauma, it’s likely underreported among men.

Eating disorder treatment for men

Eating disorder treatment for men and women is largely the same and typically includes a combination of medical supervision, individual and group therapy, nutritional support, and self-care. 

However, men may face some unique barriers to accessing care. For example, many eating disorder treatment programs only admit female patients, and there are far fewer eating disorder supports designed specifically for men. However, thanks to increased awareness, this is beginning to change. Medical professionals are becoming more aware of the importance of screening for eating disorders in men. 

As you begin to explore your options for eating disorder treatment, remember that no matter your gender, healing is possible. While it can be difficult to broach the subject, you can begin your journey to recovery by having a conversation with someone you trust, like a primary care provider. Tell your doctor what you’re experiencing, saying something like, “I’m struggling with food and exercise, and I’m worried I might have an eating disorder.” Healthcare providers are trained to have sensitive conversations, and they can provide a referral to a therapist or treatment center that offers eating disorder care for men. 

Find care with Rula

There’s a longstanding myth that eating disorders are a women’s issue. However, today we know that eating disorders can affect people of all genders. While men have more eating disorder treatment options than ever before, it can still be difficult to access care since many eating disorder services are designed for women. However, with the right support, men can overcome eating disorders and live full, healthy lives. 

If you or a man in your life needs help for an eating disorder, we want to invite you to Rula. With our extensive network of over 10,000 providers, you can find an eating disorder therapist who takes your insurance in just a few minutes. Once you make a selection you can schedule your first appointment for as soon as tomorrow and begin your journey to recovery from the comfort of home.

Find a therapist with Rula